内容紹介
Significance of the Granulocyte-to-Lymphocyte Ratio as a Prognostic Predictor in Patients with StageⅣ Colorectal Cancer Undergoing Chemotherapy
Summary
The aim of this study was to evaluate the clinical significance of the granulocyte-to-lymphocyte(G/L)ratio as a prognostic predictor in patients with StageⅣ colorectal cancer. A total of 83 patients who underwent oxaliplatin-based chemotherapy for StageⅣ colorectal cancer were enrolled in the study. Univariate analysis indicated that the G/L ratio; number of involved organs(more than one organ); performance status ≥1; noncurability; and levels of hemoglobin, C-reactive protein, albumin, alkaline phosphatase, carbohydrate antigen 19-9, and lactate dehydrogenase before chemotherapy were significant prognostic factors. Noncurability was identified to be an independent, unfavorable factor for survival on multivariate analysis. When patients were divided into 2 groups according to the G/L ratio(the median was considered the cut-off value), the median survival time of patients with a high G/L ratio(≥3.0)was significantly worse than that of patients with a low G/L ratio(<3.0; 16.1 months vs 25.4 months, p=0.03). Further studies with more patients are required to examine whether the G/L ratio is a convenient biomarker affecting survival in patients with StageⅣ colorectal cancer.
要旨
大腸癌の予後因子として,化学療法導入前のStageⅣ大腸癌に限定した報告は少ない。今回,顆粒球・リンパ球比(granulocyte-to-lymphocyte ratio: G/L比)を含む,実地臨床で得られる治療前の因子を用いて予後予測の検討を行った。oxaliplatin-baseの化学療法が導入されたStageⅣ大腸癌のうち,化学療法導入前にG/L比が評価可能であった83例を対象とした。単変量解析では,G/L比,転移臓器個数が2臓器以上,PS 1以上,非根治症例,Hb,CRP,Alb,ALP,CA19-9およびLDHが予後不良因子として抽出され,多変量解析では,非根治症例が予後不良の独立因子として同定された。G/L比のカットオフ値を3に設定し,低値群(n=44)と高値群(n=39)の2群に分類した。生存期間中央値は低値群25.4か月,高値群16.1か月で高値群が有意に予後不良であった。化学療法導入前のStageⅣ大腸癌においてG/L比は予後不良の1因子として,今後も検討すべき項目と思われた。
目次
Summary
The aim of this study was to evaluate the clinical significance of the granulocyte-to-lymphocyte(G/L)ratio as a prognostic predictor in patients with StageⅣ colorectal cancer. A total of 83 patients who underwent oxaliplatin-based chemotherapy for StageⅣ colorectal cancer were enrolled in the study. Univariate analysis indicated that the G/L ratio; number of involved organs(more than one organ); performance status ≥1; noncurability; and levels of hemoglobin, C-reactive protein, albumin, alkaline phosphatase, carbohydrate antigen 19-9, and lactate dehydrogenase before chemotherapy were significant prognostic factors. Noncurability was identified to be an independent, unfavorable factor for survival on multivariate analysis. When patients were divided into 2 groups according to the G/L ratio(the median was considered the cut-off value), the median survival time of patients with a high G/L ratio(≥3.0)was significantly worse than that of patients with a low G/L ratio(<3.0; 16.1 months vs 25.4 months, p=0.03). Further studies with more patients are required to examine whether the G/L ratio is a convenient biomarker affecting survival in patients with StageⅣ colorectal cancer.
要旨
大腸癌の予後因子として,化学療法導入前のStageⅣ大腸癌に限定した報告は少ない。今回,顆粒球・リンパ球比(granulocyte-to-lymphocyte ratio: G/L比)を含む,実地臨床で得られる治療前の因子を用いて予後予測の検討を行った。oxaliplatin-baseの化学療法が導入されたStageⅣ大腸癌のうち,化学療法導入前にG/L比が評価可能であった83例を対象とした。単変量解析では,G/L比,転移臓器個数が2臓器以上,PS 1以上,非根治症例,Hb,CRP,Alb,ALP,CA19-9およびLDHが予後不良因子として抽出され,多変量解析では,非根治症例が予後不良の独立因子として同定された。G/L比のカットオフ値を3に設定し,低値群(n=44)と高値群(n=39)の2群に分類した。生存期間中央値は低値群25.4か月,高値群16.1か月で高値群が有意に予後不良であった。化学療法導入前のStageⅣ大腸癌においてG/L比は予後不良の1因子として,今後も検討すべき項目と思われた。